Exercise-related acute renal failure

Description of Exercise-Related Acute Renal Failure... 

In 1982, we classified exercise-related acute renal failure into two types myoglobinuric acute renal failure, as had previously been reported, and non-myoglobin-related acute renal failure (exercise-induced acute renal failure). In 2002, the latter was named ALPE (Acute renal failure with severe Loin pain and Patchy renal ischemia after anaerobic Exercise) [4]. The term acute kidney injury (AKI) has recently been proposed as a patho-physiologically more correct alternative to the term acute renal failure. Therefore, exercise-induced acute renal failure in this book may be replaced by exercise-induced acute kidney injury. 

Table 1. Exercise-related acute renal failure...

As shown in Fig. 76, exercise-related acute renal failure is classified into two types myoglobinuric acute renal failure and non-myoglobinuric acute renal failure. The latter is represented by ALPE. The grade of rhabdomyolysis and the type/grade of muscle fibers affected are shown in Fig. 76. Pathogenetic factors for ALPE should be investigated in the future. 

In all case reports, the levels of creatine phosphokinase (CPK) were markedly increased to about 70 000mU/ml or more [11], Furthermore, this disorder frequently develops in people who are not accustomed to exercise, and is therefore called white-collar rhabdomyolysis [12], which indicates myoglobin-related acute renal failure. 

In relation to the term exercise-induced acute renal failure, this disorder was expressed as loin pain and acute renal failure after exercise (athletics meeting) in 1981 [24] (Fig. 24). Later, however, Nishimura and Takahara [25], Ishii et al. [26], and Nakamura et al. [27] named this disorder exercise-induced acute renal failure. Since then, this term has commonly been used [3]. 

Fujii T, Hasegawa S, Iesato K (2000) Two cases of exercise-induced acute renal failure—acute renal failure related to serum uric acid level (Japanese abstract). Nippon Jinzo Gakkai Shi (Jpn J Nephrol) 42 536... 

In 1910, Meyer-Betz reported the first published case of acute renal failure with muscular pain, weakness, and dark urine after intense exercise [5]. In 1960, Howenstine reported that this type of acute renal failure was exercise-related myoglobinuria [6], However, at this time, it was impossible to distinguish hemoglobin from myoglobin, and this type of acute renal failure was considered to be a type of heat stroke. However, in 1970, Jackson [7] reported that this disorder was exercise-related renal failure and muscle damage, and this publication led to a gradual increase in research interest in myoglobinuric acute renal failure. In 1972, Hamilton et al. [8] and Knochel [9], respectively, reported that similar cases were exertional rhabdomyolysis. Matsumoto et al.[10] first reported this disorder in Japan in 1976. 

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